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House Bill 323 – Department of Health and Welfare – Division of Medicaid, Supplementals FY23

House Bill 323 – Department of Health and Welfare – Division of Medicaid, Supplementals FY23

Niklas Kleinworth
March 16, 2023

The Idaho Spending Index serves to provide a fiscally conservative perspective on state budgeting while providing an unbiased measurement of how Idaho lawmakers apply these values to their voting behavior on appropriations bills. Each bill is analyzed within the context of the metrics below. They receive one (+1) point for each metric that is satisfied by freedom-focused policymaking and lose one (-1) point for each instance in which the inverse is true. The sum of these points composes the score for the bill.

Analyst: Niklas Kleinworth

Rating: -1

Bill Description: House Bill 323 appropriates $410,009,800 to the DHW Division of Medicaid for fiscal year 2023.

Does this budget contain hidden fund transfers or supplemental expenditures that work to enact new policy or are not valid emergency expenditures? Conversely, are fund transfers only made to stabilization funds or are supplemental requests only made in the interest of resolving valid fiscal emergencies?

Of the $410 million in supplemental appropriations provided in this legislation, about $211 million will be spent on raising the Upper Payment Limit (UPL) for providers. This funding is in response to the passage of Senate Bill 1350 in the 2022 legislative session. The fiscal note for the bill mentioned that there would be an ongoing annual savings of $66 million, starting in the 2024 fiscal year. However, the spending provided in House Bill 323 was never mentioned in the fiscal note for Senate Bill 1350. In reality, the UPL increase does not reduce Medicaid costs but merely shifts funding around.

The lack of discussion about this supplemental appropriation in the fiscal note for Senate Bill 1350 indicates that it is not a valid emergency expenditure necessary to facilitate the changes to the UPL increase.


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